Ilaj-bil- Dawa (Pharmacotherapy)

This treatment methodology is considered by Unani physicians to be natural, eco-friendly, and less intrusive and more effective than many other methods. The Unani system’s pharmacopoeia is vast, enriched with more than 2700 medicines derived from various herbal, mineral, and animal sources.

Unani System of Medicine emphasizes on maintaining health by natural ways and means through change in life style, regular exercise, regulation of diet, normal sleeping habits and by avoiding factors, which may adversely affect the quality of life.

Pharmacotherapy (Ilaj-bil- Dawa) or treatment through drugs is recommended in conditions, where these procedures are not adequate in correcting the alterations in health.It is significant that this system is based on crude/whole drug therapy in which active principle of a drug is not isolated but is allowed to co-exist with other natural parts of a plant to counteract the side effects.

In this crude drug therapy, in most of the cases, there is no direct attack on the causative organism of the disease but the internal atmosphere of the body is altered, due to that, the causative organisms are either killed or become inactive. There are herbs that act as immuno- modulators in the body by encouraging the defense mechanism of a person.

In the field of Pharmacotherapy the Unani system of medicine displays a unique wealth of knowledge and experience which went into the building up of this treatment modality. According to Unani System of medicine drugs having states opposite to those present in the diseases should be applied. Natural drugs like plants, minerals and animal drugs are more advisable in this system.

In drugs of herbal origin, these are either parts of plants e.g. seeds, roots, flowers, stem, fruits, leaves, barks, latex, exudates or the entire plant as such are used as medicine.

In drugs of animal origin, it can either be animal products like milk, urine or animal parts such as hoofs and nails, hair, flesh, organs, fats or animal as a whole e.g. crab, scorpion, earthworm etc.

In drugs made of mineral, the minerals existing in nature are also used for therapeutic purposes and consists of ores, metals and precious stones, salts, stones, clay etc.

Some other principles related to Pharmacotherapy may be mentioned as under.

This type of treatment involves the use of naturally occurring drugs, mostly herbal. Natural drugs only are used because they are locally available and have minimal or no after- effects on the body.

According to Unani System of Medicine, the choice of drugs for treatment is governed by three laws:

(i) Quality of drug in terms of temperament

(ii) Quantity of drug in terms of its weight and potency and

(iii) Time of administration

The selection of drug depends upon the nature and type of disease. The proper drug is that which is contrary to the nature and qualitative pattern of the disease i.e. its pathological temperament.

The weight and potency of the drug is determined by the nature of the affected organ; severity of the disease; and other related factors such as sex, age, weight, habit and habitat, season, built, previous treatment taken, and stage of the disease.

In Unani medicine more emphasis is given to single drug therapy after due consideration of temperament of the drug and patients.

Compound formulations are given as a second choice for synergistic, antagonistic, or detoxifying effects or simply as bases for effective ingestion and assimilation. And sometimes due to additive action or for some other reasons, the compound formulations are prescribed.

Standardization and quality control has given an important place in Pharmacy (Dawa sazi) since its beginning to minimize the side effects and toxicity of the drugs.

Mizaj-e- Advia (Drugs Temperament)

The Unani medicine presupposes that the drugs also have their own temperament due to their special constituents. The Unani System of Medicine states that the drugs have their own particular temperament due to their specific constituents. Concoctive drugs (Munḍij Adwiya) are used to prepare the morbid matter for excretion, whereas Purgative drugs (Mushil Adwiya) are used to remove morbid matter through intestine.

Some drugs are composed of ingredients having opposite qualities, one quality acting in a way contrary to the other and these qualities are accommodated in two different parts of the drug. Ingredients possessing special actions are called active principle of the drugs. This theory of temperament of drugs is based on analogy and careful experiments.

Darajaat-e- Advia (Potency of Drugs)

Drugs are graded into four degrees according to their potency. In Unani system, drugs are used when the physical means and food fail to cure a disease. Drugs of low potency should be used, as far as possible, but according to the severity of disease, we may use high potency drugs. Drugs having greater potency are sometimes harmful. When a severe disease occurs and there is danger of complete loss of energy and life, then drugs of higher potency can be used from the outset.

Drugs have been classified into four grades according to their intensity and potency

Darja-e- Awwal (Grade I) - Medicines which, after metabolism, alter the physiological condition of the body either in terms of temperature, functioning or behavior a little above the normal limits.

Darja-e- Doyam (Grade II) - Medicines which, after metabolism, alter the physiological condition of the body either in terms of temperature, functioning or behavior in partially abnormal limits

These are further sub-divided into initial, middle and last levels. Few drugs have been described as Mo’tadil (Neutral) in which, none of the above mentioned kaifiyaat (character) predominate, but it closely resemble the normal human temperament.

Mode of Action

The mechanism or mode of action of a drug can be explained only partially. For example Glycerrhiza glabra causes expectoration by relaxing and opening the passage of bronchioles but why it does so cannot be explained. However the Unani physicians have tried to explain it as follows;

The direct action of a drug is the result of its physical or acquired characters. Drugs mainly act because of its characteristics available in them i.e. by heat, coldness, moisture or dryness.

Some of the drugs have peculiar characteristics which influence the body when these drugs are administered.

Actions of drugs on various systems or organs can be described in detail in the systematic pharmacology. Some drugs can act on peculiar organ only. For example the Anaesthetics act on the nerve-endings of sensory nerves.

Use of Munzij (Coctive) and Mushil (Purgative)

Coctive is used to prepare the matters for excretion through purging or other means of excretion.

This mode of treatment is used particularly for treating chronic or obstinate diseases. Purgative is used generally followed by coctive.

Dosage and Timings

While determining the dosage of a drug, factors such as temperament and potency of drugs, temperament and age of the patient, nature of disease, severity of the disease, route of drug administration etc. must be kept in mind.

High potency drugs as severe purgatives and emetics should be avoided during summers and severe cold weather. Different types of treatment are prescribed for different stages of the same disease. Some drugs should be used only when the stomach is empty such as antihelminthic, while others should be used only after meals e.g. compounds of Iron. Mild action purgatives should be used at night and the sharp action purgatives in the morning.

Routes of Drug Administration

As far as route of drug administration is concerned, in addition to oral routes, Unani physicians also administer drugs through Zimad, Abzan, Huqna, fateela, Farzaja, Shiaf, and Tila etc. The inhalation through inspiration is also useful in curing many respiratory diseases.

Forms and Shapes of Drug Usage

There are mainly three forms of the drugs used in Unani system of medicine i.e the drugs are either formulated into solid forms e.g. Majoon, Kuhal, Marham, Qurs, etc., or liquid forms e.g. Sharbat, Joshanda, Ma-ul-Asl, Mazmaza etc.and gaseous forms e.g. Inkebaab, Shamoom, Lakhlakha.

These drugs again can be used internally or externally as per requirement of the nature and form of the disease. These drugs are further subdivided as per requirement. For example:

These forms of the drugs like Pills, Tablets, Powders, Infusions, Distillates, Decoctions, Nutool, Jawarish, Majoon, Sharbat, Khameerajat, Bakhoor, Lakhlakha, Perfumes and Inkebab etc. are used to achieve the action of required active principles of drugs. For example Jawarish is used for gastrointestinal tract while La’uooq for respiratory disorders and Khamirajaat for cardiovascular system etc.

Compounding and Correction of Harmful effects of drugs

The harmful effects are either corrected by simple methods or by compounding with other drugs, for example frying in oil decreases the irritant effect of the drug.

Drugs are compounded for the following purposes.

To potentiate the efficacy of the drugs (Synergistic effect)

To decrease the harmful or excessive effect (Antagonistic effect)

For sharp diffusion of the Drug (Sari-un- Nuffoz)

For slow diffusion of the drug (Bati-un- Nufooz)

For preservation of active principles

To increase the quantity of a drug

Substitute of Drugs (Abdaal-e- Advia)

In Unani system of Medicine, substitutes (Badal) are generally selected in reference to one or more similar actions of the drug, when the required drug is not available, or is too difficult to obtain, but as far as possible it is avoided.

Abu Bakar Muhammad Bin Zakariya Rhazi has compiled a treatise titled “Maqala fil-Abdal-il-adviyah-fit-tibb-wal-ilaj” on the subject of medicinal substitutes, wherein he has described the laws of selection of substitute of a drug. In this book he has also mentioned substitutes of some 122 single Unani drugs.

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